SURVEY FORM FOR

SEARCA FELLOWS TRACER STUDY

(Instructions to the Respondent: Kindly type or write in block letters using black or blue ballpoint pen. Please
use/attach additional sheets in case all answers cannot be accommodated in the spaces provided for each question.)

I. PERSONAL DATA
Name:

Civil Status: [ ] single [ ] married [ ] divorced [ ] widow/er

Date of Birth:
Nationality:
(mm/dd/yy)
Sex: [ ] male [ ] female

Religion: Country:
Home/Complete (Street Name & Number, Municipality/City, Province, Zip Code, Telephone, Fax, Mobile
Mailing Phone, Email)
Address/
Personal
Contact Details:

Employment (Name of Institution, Street Number, Municipality/City, Province, Zip Code, Telephone,
Address and Fax, Mobile Phone, Email)
Contact Details:

Business (Name of Business, Street Number, Municipality/City, Province, Zip Code, Telephone, Fax,
Address and Mobile Phone, Email)
Contact Details:

Preferred address for correspondence: [ ] Office [ ] Home

Educational Background:

School/University Address Date Graduated

Elementary:
High School:

College:
Graduate
School:
Honors and Awards Received:

Elementary:

High School:

College:
Graduate
School:
II. EMPLOYMENT BACKGROUND
Current
Employer:
[ ] Government agency/civil service
Classification of [ ] Educational Institution
current [ ] Regional/International Organization
employer: [ ] Non-profit/Non-government Organization
[ ] Others (Please specify) _____________________
[ ] Executive (eg. Minister, Director General, CEO)
[ ] Senior Management (eg. General Manager, Professor)
Current [ ] Middle Management (eg. Department or Division Head, Lecturer)
Position: [ ] Professional Staff (eg. Team Leader/Project Consultant)
(Please indicate [ ] Others (Please specify) _____________________
your position)
Position Title: _____________________

[ ] Research and Development

[ ] Planning
Nature of [ ] Consultancy
Current Work: [ ] Management and Administration
[ ] Teaching/Training
[ ] Others (Please specify) _____________________

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Description of
Current Work:
(Please describe
in brief)
Position
Company/Institution Duration of Employment Salary Received
Past positions Title
held before
SEARCA
graduate
scholarship
program (Please
attach/use
additional
sheets if
necessary)

Position
Company/Institution Duration of Employment Salary Received
Past positions Title
held after
completion of
graduate studies
under SEARCA
scholarship
(Please
attach/use
additional
sheets if
necessary)

3
 III. REGIONAL PROJECT EXPERIENCE
International Projects (Kindly provide additional sheets for other projects)
Type of
Funding
Name of Project/ Project Consultancy
Position Country Agency/
Duration Project (Consultancy Rate
Amount
or Research)

Local Projects (Kindly provide additional sheets for other projects)

Type of Project Funding
Name of Project/ Consultancy
(Consultancy or Position Agency/
Duration of Project Rate
Research) Amount

4
 IV. TRAININGS ATTENDED/CONDUCTED
Participation
(Resource Country Name of Institution
Title of Training Duration
Speaker, Location / Funding Agency
Participant, etc.)

V. PUBLICATIONS (last five years)

(Please indicate title, major author or co-author, date of publication, publisher, and
place of publication)

5
 VI. SCHOLARSHIP INFORMATION
How did you know about the
SEARCA scholarship program?
In what year were you awarded
the SEARCA Scholarship?
Was there another funding
agency of your scholarship aside
from SEAMEO SEARCA?
Program(s) of Study under
SEARCA Scholarship:
Graduated as of:
Changes in professional status
after completion of the degree:
What do you think were your
contributions at the institutional,
national, regional and
international level after
completion of graduate studies
under SEARCA scholarship?
(Please use additional sheets if
necessary)
[ ] Office of the Ministry of Education
[ ] University
[ ] Office of the Ministry of Agriculture
[ ] Newspaper announcement
[ ] Website announcement
[ ] Others (Please specify)
MS : _______
PhD: _______
[ ] Yes
If yes, please indicate name of agency: ____________
[ ] No
MS : _______
PhD: _______
MS: ______ semester Academic Year _________
PhD: ______ semester Academic Year _________
[ ] Transferred to another employer (indicate previous
employer) _______________
[ ] Assumed new responsibilities
[ ] Promoted (indicate previous position) ___________
[ ] Became self-employed
[ ] Pursued a different career and new field after
graduation (please specify what new field) _________
[ ] Others (Please specify) __________________
Institutional:
National:
Regional:
International:
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Do you have any suggestions for
the improvement of the SEARCA
scholarship program?

Are you fully applying the [ ] YES [ ] NO

knowledge & skills you gained
from obtaining your degree in If No, what problems have you encountered/are
your present work? encountering in carrying out your duties & responsibilities

[ ] administrative
[ ] technical
[ ] others (Please specify) ____________________

Kindly return the filled-up form using the enclosed

self-addressed envelope to:

The Graduate Scholarship Department

Attention: The Department Manager
SEAMEO SEARCA
College, Laguna 4031, Philippines
Tel No. +63 49 536 2290
Fax No. +63 49 536 7164
Email: ecc@agri.searca.org

THANK YOU VERY MUCH FOR YOUR COOPERATION